Neonatology: sacral dimples: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neonatology: sacral dimples

Sample item

A routine examination finds sacral skin markings in four newborns. Which baby most needs an ultrasound of the spine?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. A 7 mm dimple 4 cm above the anus with a hair tuft

Simple sacral dimples that are small, within about 2.5 cm of the anus, with a visible base and no other markers do not need imaging. Larger, higher dimples, or those with a hair tuft, haemangioma or skin tag, suggest occult spinal dysraphism or tethered cord and need spinal ultrasound.

Option by option

  • A. A 7 mm dimple 4 cm above the anus with a hair tuft (correct)

    Correct. Size, height above the anus and an overlying tuft are features of occult dysraphism.

  • B. A 3 mm dimple 1 cm above the anus, base visible

    A small low dimple with a visible base is a benign finding.

  • C. A shallow dimple within the gluteal cleft

    A shallow dimple in the cleft is a benign finding.

  • D. A 4 mm dimple 2 cm above the anus, no other marks

    A small dimple within 2.5 cm of the anus with no other markers is benign.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, A 7 mm dimple 4 cm above the anus with a hair tuft. Simple sacral dimples that are small, within about 2.

Why is "A 3 mm dimple 1 cm above the anus, base visible" not the answer?

A small low dimple with a visible base is a benign finding.

Why is "A shallow dimple within the gluteal cleft" not the answer?

A shallow dimple in the cleft is a benign finding.

Why is "A 4 mm dimple 2 cm above the anus, no other marks" not the answer?

A small dimple within 2.5 cm of the anus with no other markers is benign.

What concept does this question test?

It tests Neonatology: sacral dimples in Pediatrics. 5 cm of the anus, with a visible base and no other markers do not need imaging. Larger, higher dimples, or those with a hair tuft, haemangioma or skin tag, suggest occult spinal dysraphism or tethered cord and need spinal ultrasound.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatology: sacral dimples?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.